Effects of graded upper limb exercise on PICC‑related complications in patients with hematological malignancies

ZHANG Jia-si; TAN Fang-fang; HUANG Fu-lin; XIE Da-li; ZHOU Cheng-yue; PENG Yuan-yuan; QIN Juan; XU Shuang-nian; LUO Nan

doi:10.11659/jjssx.12E025125

您当前的位置：

首页 >

文章列表页 >

Effects of graded upper limb exercise on PICC‑related complications in patients with hematological malignancies

Clinical Research | 更新时间：2026-07-24

- Effects of graded upper limb exercise on PICC‑related complications in patients with hematological malignancies
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 35, Issue 7, Pages: 633-637(2026)
- 作者机构：
  
  陆军军医大学第一附属医院血液病中心，重庆 400038
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.12E025125
  CLC： R472
- Received：25 December 2025，
  
  Online First：24 July 2026，
  
  Published：25 July 2026
- 稿件说明：
移动端阅览
张佳思,谭方方,黄福麟等.阶梯式上肢运动操对血液肿瘤患者PICC术后并发症的影响[J].局解手术学杂志,2026,35(07):633-637.

ZHANG Jia-si,TAN Fang-fang,HUANG Fu-lin,et al.Effects of graded upper limb exercise on PICC‑related complications in patients with hematological malignancies[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(07):633-637.
张佳思,谭方方,黄福麟等.阶梯式上肢运动操对血液肿瘤患者PICC术后并发症的影响[J].局解手术学杂志,2026,35(07):633-637. DOI： 10.11659/jjssx.12E025125.

ZHANG Jia-si,TAN Fang-fang,HUANG Fu-lin,et al.Effects of graded upper limb exercise on PICC‑related complications in patients with hematological malignancies[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(07):633-637. DOI： 10.11659/jjssx.12E025125.

摘要

目的

探讨阶梯式上肢运动操对血液肿瘤患者经外周置入中心静脉导管（PICC）术后并发症的影响。

方法

采用回顾性队列研究方法，选取我院收治的行PICC的血液肿瘤患者314例，将2020年1月至2021年12月接受常规维护的168例患者设为常规组，将2022年1月至2023年12月接受常规维护联合阶梯式上肢运动操的146例患者设为观察组。比较2组患者PICC置入术后28 d内症状性导管相关性血栓（CRT）发生率、发生部位及临床症状。记录患者无症状性CRT的生存率及生存时间、上肢功能障碍及其他并发症发生情况。

结果

观察组患者术后7 d内症状性CRT发生率低于常规组，术后28 d内症状性CRT总发生率低于常规组，差异均有统计学意义（

0.05）。2组患者术后8~28 d症状性CRT发生率比较，差异均无统计学意义（

0.05）。

Kaplan

Meier

生存分析显示，观察组患者累计无症状性CRT生存率高于常规组（

Log

rank χ

²=8.357，

=0.004）。在CRT发生部位方面，观察组患者肱静脉症状性CRT发生率低于常规组，差异有统计学意义（

0.05）；2组患者腋静脉、贵要静脉、导管内症状性CRT发生率及不同症状CRT发生率比较，差异均无统计学意义（

0.05）。观察组患者上肢功能障碍发生率低于常规组，差异有统计学意义（

0.05）；2组患者导管移位/脱出、导管堵塞、穿刺部位出血发生率比较，差异无统计学意义（

0.05）。

结论

阶梯式上肢运动操可降低血液肿瘤患者PICC术后症状性CRT及上肢功能障碍的发生风险，且不会增加导管移位/脱出、穿刺部位出血等并发症，有助于促进置管侧肢体功能恢复。

Abstract

Objective

To investigate the effects of graded upper limb exercise on the complications after peripherally inserted central catheter （PICC） surgery in patients with hematologic malignancies.

Methods

A retrospective cohort study was conducted. A total of 314 patients with hematologic malignancies who underwent PICC surgery at our hospital were selected. A total of 168 patients who received routine care from January 2020 to December 2021 were designated as the conventional group， while 146 patients who received routine care plus graded upper limb exercise from January 2022 to December 2023 were designated as the observation group. The two groups were compared in terms of the incidence， location， and clinical symptoms of symptomatic catheter related thrombosis （CRT） within 28 days after PICC surgery. In addition， the survival rate and survival time of patients with asymptomatic CRT， as well as the occurrence of upper limb dysfunction and other complications were recorded.

Results

The observation group had significantly lower symptomatic CRT withi

n 7 days postoperatively and overall incidences of symptomatic CRT within 28 days postoperatively than the conventional group， with statistically significant differences （

0.05）. No statistically significant difference was found in the incidence of symptomatic CRT from 8 to 28 days postoperatively between the two groups （

0.05）.

Kaplan

‑

Meier

survival analysis revealed a significantly higher cumulative survival rate of asymptomatic CRT in the observation group compared with the conventional group （

Log

‑

rank

²=8.357，

=0.004）. Regarding CRT location， the observation group had a lower incidence of symptomatic CRT in the brachial vein compared with the conventional group， with statistically significant difference （

0.05）， whereas no significant differences were found in the incidence of symptomatic CRT in the axillary vein， basilic vein， and intracatheter， or in the incidence of CRT-associated symptoms between the two groups （

0.05）. The incidence of upper limb dysfunction in the observation group was lower than that in the conventional group， with statistically significant difference （

0.05）. No significant differences were found in the incidences of catheter migration/dislodgement， catheter occlusion， or puncture site bleeding between the two groups （

0.05）.

Conclusion

Graded upper limb exercise reduces the risk of symptomatic CRT and upper limb dysfunction after PICC surgery in patients with hematologic malignancies，without increasing complications such as catheter migration/dislodgement or puncture site bleeding，and contributes to the recovery of limb function on the catheterized side.

关键词

Keywords

references

吴玉芬，杨巧芳，夏琪 . 静脉输液治疗专科护士培训教材［M］. 北京：人民卫生出版社， 2021 ： 217 .

Wang P ， Soh KL ， Ying Y ， et al . Risk of VTE associated with PORTs and PICCs in cancer patients： a systematic review and meta-analysis ［J］. Thromb Res ， 2022 ， 213 ： 34 - 42 . doi： 10.1016/j.thromres.2022.02.024 http://dx.doi.org/10.1016/j.thromres.2022.02.024 .

康军仁，孙文彦 . 经外周静脉置入中心静脉导管相关上肢静脉血栓的研究进展［J］. 中华临床营养杂志， 2022 ， 30 （ 4 ）： 249 - 256 . doi： 10.3760/cma.j.cn115822-20220406-00067 http://dx.doi.org/10.3760/cma.j.cn115822-20220406-00067 .

Gorski LA . Update： the 2024 infusion therapy standards of practice ［J］. Home Healthc Now ， 2024 ， 42 （ 4 ）： 198 - 205 . doi： 10.1097/NHH.0000000000001270 http://dx.doi.org/10.1097/NHH.0000000000001270 .

蒋庆娟，王明慧，应燕萍 . 运动锻炼在预防肿瘤患者导管相关性血栓中的应用进展［J］. 血栓与止血学， 2023 ， 29 （ 2 ）： 97 - 101 . doi： 10.3969/j.issn.1009-6213.2023.02.007 http://dx.doi.org/10.3969/j.issn.1009-6213.2023.02.007 .

Chen P ， Wan G ， Zhu B . Incidence and risk factors of symptomatic thrombosis related to peripherally inserted central catheter in patients with lung cancer ［J］. J Adv Nurs ， 2021 ， 77 （ 3 ）： 1284 - 1292 . doi： 10.1111/jan.14666 http://dx.doi.org/10.1111/jan.14666 .

Levi M . Clinical characteristics of disseminated intravascular coagulation in patients with solid and hematological cancers ［J］. Thromb Res ， 2018 ， 164 （ 1 ）： S77 - S81 . doi： 10.1016/j.thromres.2018.01.016 http://dx.doi.org/10.1016/j.thromres.2018.01.016 .

胡琼颖，李蕾蕾，黄爱微 . 围手术期住院患者PICC置管后恐动症发生危险因素分析［J］. 浙江创伤外科， 2025 ， 30 （ 8 ）： 1594 - 1596 . doi： 10.3969/j.issn.1009-7147.2025.08.060 http://dx.doi.org/10.3969/j.issn.1009-7147.2025.08.060 .

葛朋莉，江雷振，梁梅菊 . 2s主动握球运动对PICC置管患者CRT的预防价值及其对腋静脉血液流速的影响［J］. 医学理论与实践， 2024 ， 37 （ 9 ）： 1578 - 1581 . doi： 10.19381/j.issn.1001-7585.2024.09.052 http://dx.doi.org/10.19381/j.issn.1001-7585.2024.09.052 .

郑红建，汪丽萍，何丽娟，等 . 握拳锻炼对神经内科患者上肢深静脉血栓预防的研究［J］. 中国预防医学杂志， 2019 ， 20 （ 5 ）： 475 - 478 . doi： 10.16506/j.1009-6639.2019.05.029 http://dx.doi.org/10.16506/j.1009-6639.2019.05.029 .

成芳，傅麒宁，何佩仪，等 . 输液导管相关静脉血栓形成防治中国专家共识（2020版）［J］. 中国实用外科杂志， 2020 ， 40 （ 4 ）： 377 - 383 . doi： 10.19538/j.cjps.issn1005-2208.2020.04.03 http://dx.doi.org/10.19538/j.cjps.issn1005-2208.2020.04.03 .

Ellis ML ， Okano S ， McCann A ， et al . Catheter-related thrombosis incidence and risk factors in adult cancer patients with central venous access devices ［J］. Intern Med J ， 2020 ， 50 （ 12 ）： 1475 - 1482 . doi： 10.1111/imj.14780 http://dx.doi.org/10.1111/imj.14780 .

Liu K ， Zhou Y ， Xie W ， et al . Handgrip exercise reduces peripherally-inserted central catheter-related venous thrombosis in patients with solid cancers： a randomized controlled trial ［J］. Int J Nurs Stud ， 2018 ， 86 ： 99 - 106 . doi： 10.1016/j.ijnurstu.2018.06.004 http://dx.doi.org/10.1016/j.ijnurstu.2018.06.004 .

刘媛芳，韦巧玲，黎容清，等 . 肿瘤患者PICC相关性血栓形成危险因素及风险评估研究进展［J］. 中国医药导报， 2020 ， 17 （ 28 ）： 52 - 55 . doi： 10.20047/j.issn1673-7210.2020.28.013 http://dx.doi.org/10.20047/j.issn1673-7210.2020.28.013 .

袁若颖，陈梦宇，王子纯 . 渐进式肩部活动训练对植入手臂式输液港合并肩关节疼痛肿瘤患者的作用研究［J］. 吉林医学， 2025 ， 46 （ 12 ）： 3140 - 3143 . doi： 10.3969/j.issn.1004-0412.2025.12.071 http://dx.doi.org/10.3969/j.issn.1004-0412.2025.12.071 .

沈悌，赵永强 . 血液病诊断及疗效标准［M］. 4版 . 北京：科学出版社， 2018 ： 87 - 294 .

胡金月 . PICC置管对乳腺癌术后化疗患者生活质量及上肢功能的影响［J］. 西藏医药， 2020 ， 41 （ 2 ）： 15 - 17 .

中国抗癌协会肿瘤护理专业委员会 . 成人PICC堵塞的预防及处理专家共识［J］. 中国循证医学杂志， 2024 ， 24 （ 3 ）： 249 - 257 . doi： 10.7507/1672-2531.202311143 http://dx.doi.org/10.7507/1672-2531.202311143 .

钟燕慧，许丽贞，陈燕丽，等 . 上肢运动方案联合运动日记对肿瘤PICC置管患者功能锻炼依从性和血栓发生率的影响［J］. 中外医学研究， 2021 ， 19 （ 11 ）： 177 - 180 . doi： 10.14033/j.cnki.cfmr.2021.11.066 http://dx.doi.org/10.14033/j.cnki.cfmr.2021.11.066 .

周晔 . 不同频次的握拳运动对PICC相关性血栓的影响［D］. 南京：南京医科大学， 2015 .

许辉琼，苏效添，敬文莉，等 . 肿瘤患者PICC相关性血栓形成及其对置管静脉血流状态影响的临床研究［J］. 四川大学学报（医学版）， 2023 ， 54 （ 3 ）： 648 - 652 . doi： 10.12182/20230560701 http://dx.doi.org/10.12182/20230560701 .

李荣华，何佩仪，杜萍，等 . 肿瘤患者经外周穿刺中心静脉置管后血栓形成的高危因素及对导管相关性血栓的诊断价值［J］. 实用医学杂志， 2020 ， 36 （ 16 ）： 2309 - 2314 . doi： 10.3969/j.issn.1006-5725.2020.16.028 http://dx.doi.org/10.3969/j.issn.1006-5725.2020.16.028 .

杨婷婷 . PICC置管患者恐动症现状及影响因素的混合性研究［D］. 合肥：安徽中医药大学， 2025 . doi： 10.26922/d.cnki.ganzc.2025.000543 http://dx.doi.org/10.26922/d.cnki.ganzc.2025.000543 .

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Clinical advances in control strategies for the dorsal venous complex during robot-assisted radical prostatectomy

Predictive value of serum HDAC1 and PSGL-1 for pulmonary infection after thoracoscopic radical resection of lung cancer

Application effect of tranexamic acid combined with liposomal bupivacaine in hip arthroplasty

Risk factors for blood loss in unilateral biportal endoscopic lumbar interbody fusion for single-segment grade Ⅰ lumbar spondylolisthesis

Pathogenesis and therapeutic advances in chronic wounds of diabetic foot

Related Author

No data

Related Institution

No data

⁰